Search Results (2,139)

Spontaneous rhythmic performance is a fundamental feature of human movement, well established in biomechanical models (EBMs) but less understood in complex physical fitness exercises (PFEs). This study examined the task dependency of spontaneous rhythmic performance across three EBMs (walking, hopping, finger tapping) and seven PFEs (hip abduction, back extension, sit-up, push-up, shoulder abduction, squat, lunge). A total of 15 men and 15 women performed each task at a self-selected pace while wearing inertial sensors. Measures included spontaneous motor tempo (SMT), temporal structure metrics, and their within- and between-trial individual variability (%CV) (ANOVA, SPSS 28.0, p ≤ 0.05). SMT was task-dependent, with EMB tasks being near ~2 Hz (walking: 1.82 ± 0.10 Hz; hopping: 2.08 ± 0.22 Hz; finger tapping: 1.89 ± 0.43 Hz) and PFEs being slower (0.36–0.68 Hz). Temporal structure mirrored these differences with shorter cycle and phase durations in EBM than PFE tasks, with relative phase durations consistently at about a 1:1 ratio. Τhe overall low %CV indicated stable performance (within-trial: 1.4–7.5%; between-trial: 0.5–7.8%). The results highlight the task dependency of SMT and temporal structure, as well as the robustness of an overarching internal timing framework supporting rhythmic motor control across diverse movement contexts. Full article

Background/Objectives: Sitting is linked to health problems, including back pain. Sitting posture is commonly measured in the laboratory, but it remains unclear how this relates to real-world spine posture. Methods: A cross-sectional study of pain-free adults conducted measurements in “laboratory” and “real-world” settings. Wearable motion sensors recorded lumbar spine angular orientation to compare lumbar spine flexion angle during sitting postures in between settings. Gaussian mixture models defined participant-specific modes and overall probability distributions of real-world sitting posture. Measures included periods of real-world sedentary/activity behaviours and trunk postural control (laboratory). Results: Laboratory measures of lumbar angle were more flexed during questionnaire (30.0°) than upright (19.8°) sitting. The angle in unstable sitting was intermediate (27.1°). Spine posture in unstable sitting correlated with real-world overall mean posture (r = 0.49–0.54) and most frequent mode (r = 0.47). Upright laboratory sitting posture correlated with real-world second most frequent mode (r = 0.54). Sitting less (r = 0.45) and walking more (r = 0.41) in the real world related to better balance performance and lumbar spine coordination. Conclusions: Spine posture in an unstable sitting laboratory task had the closest association with real-world sitting but does not replicate the diversity of spine postures adopted in real-world sitting. Wearable sensors are viable to study real-world postures. Full article

Conventional hip disarticulation prostheses often require amputees to produce limited leg-lifting torque through exaggerated pelvic motion, resulting in complex control and pronounced gait abnormalities. To overcome the limitations, we present a mapping control strategy for a powered hip disarticulation prosthesis aimed at improving gait symmetry. A quaternion-based method was implemented to capture hip joint kinematics, while a gated recurrent unit (GRU) neural network was trained to model the kinematic relationship between the intact and prosthetic limbs, enabling biomimetic trajectory control. Validation experiments showed that trajectory similarity between predicted and actual motions increased with walking speed, reaching 98.12% at 3.0 km/h. Comparative walking tests revealed an 84.00% improvement in hip flexion angle with the powered prosthesis over conventional designs. Notable improvements in gait symmetry were observed: stride symmetry (measured by SI and RII) improved by 23.21% and 19.28%, respectively, while hip trajectory symmetry increased by 68.07% (SI) and 47.59% (RII). These results confirm that the GRU-based kinematic mapping model offers robust trajectory prediction and that the powered prosthesis significantly enhances gait symmetry, delivering more natural and biomimetic motion. Full article

Background and Objectives: Knee arthroplasty often leads to marked postoperative muscle weakness, with strength losses of up to 62% in the first month, contributing to functional impairment and patient dissatisfaction. Blood flow restriction (BFR) training, which combines low-load exercise with partial vascular occlusion, has shown promise in enhancing muscle strength across musculoskeletal conditions and may represent a valuable rehabilitation strategy for this vulnerable population. This review aimed to systematically evaluate the effectiveness and safety of BFR training in improving muscle strength and functional outcomes following knee arthroplasty. Materials and Methods: This systematic review was prospectively registered within PROSPERO (CRD420250652404) and conducted according to PRISMA guidelines. PubMed, Embase, and Cochrane Library were searched through February 2025 for randomized controlled trials (RCTs) investigating BFR training in knee arthroplasty patients. Study selection, data extraction, and risk of bias assessment (RoB 2 tool) were performed independently by two reviewers. Eligible trials reported muscle strength and/or functional outcomes as primary or secondary endpoints. Results: Four RCTs, including 148 patients undergoing total knee arthroplasty (mean age: 67 ± 6.5 years), met the inclusion criteria. All applied preoperative BFR training for 4–8 weeks with heterogeneous protocols. Two trials demonstrated significant improvements in muscle strength (1 RM leg press, 1 RM knee extension; large effect sizes) and functional outcomes (6 min walk test, 30 s sit-to-stand; earlier recovery), favoring BFR. The remaining studies showed no significant between-group differences, though moderate-to-large effect sizes generally favored BFR training. No adverse events were reported. Conclusions: Prehabilitation with BFR training shows considerable potential to enhance early postoperative muscle strength and functional recovery in patients undergoing knee arthroplasty, particularly when compared with usual care lacking structured preoperative intervention. The evidence to date suggests that BFR is a safe and well-tolerated strategy, offering an alternative for patients who cannot perform high-load resistance training. Its favorable safety profile, combined with the potential to accelerate functional recovery, highlights the promise of BFR for reducing rehabilitation costs and healthcare utilization. Nonetheless, larger, high-quality RCTs with standardized protocols and extended follow-up are required to confirm these preliminary findings and establish clear clinical guidelines for their implementation. Full article

This study aimed to evaluate the effects of acupuncture–moxibustion (AM) combined with Locomotor Training (LT) on functional recovery after surgery for Cervical Intervertebral Disc Herniation (IVDH) in dogs. Seventy-nine dogs undergoing ventral slot decompression (VSD) between 2022 and 2025 were enrolled and assigned to either the AM plus LT group (ALRG group) or the LT-only group (LRG group) based on postoperative rehabilitation protocols. To control for bias, post hoc analysis used propensity score matching (PSM) stratified by Rusbridge Grade. Primary outcomes included time to standing and walking recovery, along with Olby scores at five postoperative time points. Secondary endpoints included postoperative analgesic usage rate and duration, as well as long-term prognosis at 6–8 months postoperatively. After PSM, each group comprised 20 dogs. Compared with the LRG group, the ALRG group demonstrated shorter time to standing and walking recovery, better Olby score improvement, and significantly reduced opioid usage duration. Long-term follow-up revealed a higher complete success rate in the ALRG group. All trends were more pronounced in severe cases classified as Rusbridge grades 3 and 4. This study demonstrates the clinical feasibility of combining AM with LT rehabilitation for postoperative recovery in dogs with cervical IVDH. It provided new evidence for optimizing postoperative rehabilitation protocols and supports future large-scale prospective studies. Full article

Elevated plasma homocysteine (tHcy) is a modifiable risk factor for stroke and cardiovascular disease, influenced by genetic and lifestyle factors. Resistance-based training may reduce tHcy, but the impact of methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism remains unclear. This study examined the effects of a 26-week combined aerobic and resistance training program on stroke-related risk factors and tHcy levels in patients with chronic ischemic stroke, stratified by MTHFR genotype. Forty-six patients (mean age: 57.7 ± 8.9 years) completed supervised training three times per week. Assessments before and after the intervention included anthropometry, cardiorespiratory fitness, biochemical markers, and tHcy. Dietary intake was monitored and remained stable. Significant improvements were observed in body weight, fat mass, waist-to-hip ratio, VO₂max, and 6 min walk distance. tHcy decreased significantly overall (p < 0.01), with reductions confined to the CC genotype group (p < 0.01). BMI declined in CC and CT groups (p < 0.01 and p < 0.05), while fat-free mass, triglycerides, fasting glucose, and blood pressure showed no changes, likely due to pharmacological control. These findings suggest that combined training improves body composition and functional capacity, while genotype-specific reductions in tHcy highlight the potential of personalized rehabilitation strategies integrating genetic and nutritional considerations in stroke care. Full article

Improvements in exoskeletons and robotic systems are gaining increasing attention because of their potential to improve neuromuscular rehabilitation and assist people in their daily activities, significantly improving their quality of life. However, the high cost and complexity of current devices limit their accessibility to many patients and rehabilitation centers. This work presents the design and development of a low-cost walking exoskeleton, conceived to offer an affordable and simple alternative. The system uses a compact eight-bar mechanism with only one degree of freedom per leg, drastically simplifying motorization and control. The exoskeleton is customized for each patient using a synthesis process based on evolutionary algorithms to replicate a predefined gait. Despite the reduced number of degrees of freedom, the resulting mechanism perfectly matches the desired ankle and knee trajectories. The device is designed to be lightweight and affordable, with components fabricated using 3D printing, standard aluminum bars, and one actuator per leg. A working prototype was fabricated, and its functionality and gait accuracy were confirmed. Although limited to a predefined gait pattern and requiring crutches for balance and steering, this exoskeleton represents a promising solution for rehabilitation centers with limited resources, offering accessible and effective gait assistance to a wider population. Full article

Incomplete spinal cord injury (iSCI) results in impaired postural control and walking ability. Visual over-reliance may occur in iSCI individuals to maintain postural control. This can challenge their postural stability in various contexts of daily life activities. The present study assessed the feasibility, acceptability, and preliminary outcomes of balance training with intermittent visual deprivation using stroboscopic glasses on postural control and visual reliance during quiet standing in iSCI individuals. Training impact on walking performance was also evaluated. Seven chronic iSCI individuals participated in a 6-week home-based balance training program, three times weekly, using stroboscopic glasses. Postural and walking abilities were assessed pre- and post-training using a bipedal stance test (BST) and 10 m walking test (10 MWT). BST was performed, with open-eyes (OE) and closed-eyes (CE), on a force plate for three 30 s trials. The center of pressure (CoP) variables included were CoP area (A-CoP) and CoP mean velocity (MV-CoP). Romberg ratios (CE/OE) for two CoP variables were calculated. Duration and speed were measured in 10 MWT. Intervention feasibility was assessed using the feasibility and acceptability questionnaire. Data from able-bodied individuals were recorded and used as references of physiological performance. iSCI individuals were significantly less stable and showed visual over-reliance for postural steadiness compared to controls. Also, their walking ability was impaired. All iSCI individuals completed the training (adherence rate: 84%) and rated it highly feasible. A-CoP and MV-CoP significantly reduced after training in CE condition (p = 0.018, respectively) but not in OE condition (p > 0.05). The Romberg ratio of A-CoP was significantly lower (p = 0.018), but the Romberg ratio of MV-CoP was not (p > 0.05). A significant reduction in duration and increase in speed (p = 0.018, respectively) in performing the 10 MWT were observed. Preliminary findings from this explorative study indicated that 6-week home-based balance training with intermittent visual deprivation was feasible, acceptable, and had promising potential benefits in improving postural control with a reduction in visual over-reliance in iSCI individuals. The training enhanced also their walking performance. Full article

Background/Objectives: Impaired balance and general mobility are common complications of Parkinson‘s disease (PD) and are largely caused by bradykinesia and hypokinesia. Although previous studies have shown that patients can increase the speed and amplitude of movement with training, apathy, which is also common among people with PD, reduces this prospect. Training with light pods was originally developed for athletes to enhance agility in a way that is motivating. However, this type of training could be ideal for individuals with PD and possibly reduce bradykinesia and its effects. This study used a longitudinal interventional design without a control group to explore the effects of a four-week agility training with light equipment on balance and general mobility in patients with PD, as well as to assess motivational properties. Methods: Seven individuals with PD of the motor subtype “akinetic–rigid” participated in this study. Each participant received training three times per week for four weeks. The training session consisted of five rounds; in each round, participants had to turn off 20 lights. Measurements were performed one and a half weeks before training, at the beginning of the program, and at the end of the program. Balance was assessed with Mini-BESTest, general mobility with Timed Up and Go (TUG), transfer skills with 5× Sit to Stand, walking speed with the 10 m walking test, and the ability to turn on a spot with the 360° Turn Test. Motivational aspects of training were assessed after each training session, with scoring on a scale of 0–10. Results: The training significantly improved overall balance (p < 0.001), especially reactive postural control, sensory orientation, and dynamic gait, while anticipatory balance remained unchanged. Turning ability improved, but mobility, transfer ability, and walking speed did not. Motivation remained consistently high across participants. Conclusions: A four-week light-based agility training program can improve balance and turning ability in people with PD and appears to be motivating. However, no clear effects were found for general mobility, transfer skills, or walking speed. Given the small sample size and absence of a control group, these findings should be interpreted with caution. Full article

Knee osteoarthritis (OA) is a prevalent condition in older adults that often results in impaired gait and balance, increased risk of falls, and reduced quality of life. Conventional clinical assessments may not adequately capture these deficiencies. This study investigated the gait and balance of elderly individuals with knee OA using wearable inertial measurement units (IMUs). Forty-four participants with Kellgren–Lawrence grade 2–3 knee OA (71.23 ± 5.75 years) and forty-five age-matched controls (70.87 ± 4.30 years) completed dynamic balance (balance board), static balance (single-leg stance), ‘timed up and go’ (TUG), and normal walking tasks. Between 2 and 8 IMUs, depending on the task, were placed on the head, chest, waist, knees, ankles, soles, and balance board to record kinematic data. Balance was quantified using absolute angular velocity and linear acceleration, with group differences analyzed by MANOVA and Bonferroni-adjusted univariate tests. The participants with knee OA exhibited greater gait asymmetry, although the difference was not significant. However, they consistently demonstrated higher absolute angular velocities than controls across most body segments during static and dynamic tasks, indicating reduced postural stability. No group differences were observed in TUG performance. These findings suggest that IMU-based measures, particularly angular velocity, are sensitive to balance impairment detection in knee OA. Incorporating IMU technology into clinical assessments may facilitate early identification of instability and guide targeted interventions to reduce fall risk. Full article

Dynamic mobilization exercises (DME) are an effective strategy to prevent musculoskeletal injuries and promote back health in sport horses. Previous studies focused mainly on multifidus muscle cross-sectional area, with limited data on locomotion and adaptation timing. This study evaluated locomotor changes using accelerometry, over 8 weeks of DME application in 14 sedentary horses: a DME group (n = 8) performing 10 different DME (3 neck flexions, 1 neck extension and 3 lateral bending exercises to each side), 5 repetitions of each DME per session, 3 sessions/week, and a control group (n = 6), that continued with their daily routine activities without any other training. During the study period, all horses were housed in medium-sized paddocks. Accelerometric measurements were performed at walk and trot before intervention, 2 h and 24 h after a DME session, and at 2, 4, 6, and 8 weeks. The DME group showed significant increases in dorsoventral displacement and dorsoventral and mediolateral activities from week 4, at both walk and trot, which then stabilized. Longitudinal activity increased from week 2 on trot and from week 4 at walk. Locomotor symmetry and stride length improved at week 6, while stride frequency decreased at week 8; velocity remained unchanged. These findings indicate that DME enhances dorsoventral, mediolateral and longitudinal activities, producing longer, more symmetrical strides. Overall, DME appears to promote more symmetrical movement patterns. Full article

Functional hallux limitus (FHL) is a biomechanical condition defined by restricted motion of the first metatarsophalangeal joint during walking, which may impair stability and increase fall risk in older adults. This study compared fall risk between patients with asymptomatic FHL and healthy controls using validated assessments. The case–control design included 40 participants over 65 years, divided into 20 with FHL and 20 controls. Mobility was evaluated with the Timed Up and Go Test, postural stability with the Berg Balance Scale, and fear of falling with the Falls Efficacy Scale—International (FES-I). Spatiotemporal gait parameters were measured using an inertial measurement unit (IMU). No significant differences were found between groups in the Timed Up and Go Test (p = 0.694), Berg Balance Scale (p = 0.903), Falls Efficacy Scale—International (p = 0.913), or spatiotemporal parameters. These results suggest that asymptomatic FHL does not significantly affect mobility, stability, or fear of falling in older adults, indicating that it is not a determining factor for fall risk under controlled conditions. Further research is needed in less controlled settings or in patients with painful FHL. Full article

Accurate prediction of component content in the rare-earth extraction and separation process is crucial for control system design, product quality control, and optimization of energy consumption. To improve prediction accuracy and modeling efficiency, this paper proposes a model for predicting component content based on an Improved Black-winged Kite Algorithm-Optimized Stochastic Configuration Network (IBKA-SCN). First, we develop an Improved Black-winged Kite Algorithm (IBKA), incorporating good point set initialization and Lévy random-walk strategies to enhance global optimization capability. Theoretical convergence analysis is provided to ensure the stability and effectiveness of the algorithm. Second, to address the issue that constraint parameters and weight-scaling factors in Stochastic Configuration Network (SCN) rely on manual experience and struggle to balance accuracy and efficiency, IBKA is employed to adaptively search for the optimal hyperparameter combination. The applicability of IBKA-SCN is corroborated through four real-world regression tasks. Finally, the effectiveness of the proposed method is validated through an engineering case study on predicting component content. The results show that IBKA-SCN significantly outperforms existing mainstream methods in both prediction accuracy and modeling speed. Full article

Background and Objectives: Frail patients after open-heart surgery often experience worse treatment outcomes in improving physical performance and muscle strength. As the functional recovery of frail patients after open-heart surgery is slower, conventional rehabilitation is frequently insufficient to achieve treatment goals. Therefore, the inclusion of additional exercise interventions in cardiac rehabilitation is becoming more relevant. The aim of this study was to assess and compare the effectiveness of additional exercise interventions—multicomponent and computer-based programs—applied along with conventional cardiac rehabilitation in improving the functional capacity and strength of frail patients after open-heart surgery. Materials and Methods: The population of this single-center, three-arm, parallel-group, randomized controlled trial comprised 153 frail patients aged more than 65 years who underwent open-heart surgery. All patients were randomized into three groups: control (CG, n = 51), intervention 1 (IG-1, n = 51), and intervention 2 (IG-2, n = 51). All groups received conventional rehabilitation program six times/week, while the IG-1 additionally received the multicomponent dynamic training program 3 times/week, and the IG-2, the combined computer-based program 3 times/week. The primary outcome measure was change in the Short Physical Performance Battery (SPPB) score. Secondary outcome measures included the 6 min walk distance (6MWD), peak workload, grip strength, and leg press. Primary and secondary outcome measures were assessed before and after cardiac rehabilitation. Results: A total of 138 patients completed rehabilitation (46 in each group), and their data were included in the main analysis that followed a per-protocol approach. Although significant differences in the primary outcome—the SPPB score—were found in each group while performing within-group comparisons (p < 0.001), no significant pre-to-post rehabilitation differences were observed compared to all three groups (p = 0.939), and the effect sizes were small. Regarding secondary outcome measures, within-group comparison revealed significant differences in all parameters of all groups (p < 0.05), except for the grip strength of both hands in the IG-1. Between-group comparisons showed that the pre-to-post 6MWD difference between the CG and the IG-1 was significant (p = 0.014), but the effect size was small (ES = 0.240). Moreover, significant pre-and-post leg press 1RM differences (p < 0.001) were found between the CG and the IG-1 as well as between the CG and the IG-2 with the effect sizes being moderate (ES = 0.480) and large (ES = 0.613), respectively. Conclusions: Within-group comparison showed that all three rehabilitation programs are effective in improving almost all parameters of physical performance and muscle strength in frail patients after open-heart surgery. However, between-group comparisons indicated that computer-based interventions were more effective in improving leg press 1RM with a large effect size, while multicomponent training resulted in more effective gains in the 6MWD, although with a small effect size. These findings suggest that in clinical practice, computer-based exercise programs may be more suitable for patients with muscle weakness, while multicomponent exercise programs may be for those with reduced endurance. Full article

Background: Evidence on how everyday walking and sleep relate to mood in health profession students from Central–Eastern Europe remains limited. Methods: We conducted a cross-sectional study among 277 Romanian medical students. Data were collected using validated instruments for physical activity (IPAQ-SF), sleep quality (PSQI), and depressive/anxiety symptoms (HADS). Associations were examined using bivariate and multivariable regression models, including sex-stratified analyses. Results: In bivariate analysis, total physical activity was inversely correlated with depressive symptoms (ρ = −0.19, p < 0.001). However, in the multivariable model, this effect was not statistically significant after controlling for other factors. Poor sleep quality emerged as the dominant independent predictor of both depression (β = 0.37, p < 0.001) and anxiety (β = 0.40, p < 0.001). Walking time and frequency were specifically protective against depressive symptoms. Sex-stratified analyses revealed distinct patterns: female students benefited more from walking, whereas male students showed stronger associations between overall physical activity and lower depressive symptoms. Conclusions: Within the constraints of a cross-sectional design, this study provides novel evidence from Eastern Europe that sleep quality and physical activity are central to student mental health. Psychological benefits of walking appear sex-specific, and the null mediation finding suggests benefits operate via direct or unmodelled pathways. Sleep is a critical independent target for tailored, lifestyle-based strategies. Full article